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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(05): e696-e701
DOI: 10.1055/s-0042-1757304
Artigo Original
Joelho

Causes of Revision of Total Knee Arthroplasties in a Tertiary Hospital in Brazil

Article in several languages: português | English
Alan de Paula Mozella 
1   Departamento de Ortopedia e Traumatologia, Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.
,
Hugo Alexandre de Araújo Barros Cobra 
1   Departamento de Ortopedia e Traumatologia, Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.
,
Sandra Tie Nishibe Minamoto 
1   Departamento de Ortopedia e Traumatologia, Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.
,
Rodrigo Salim 
2   Departamento de Ortopedia e Anestesiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), São Paulo, SP, Brasil.
,
Ana Carolina Leal 
3   Divisão de Ensino e Pesquisa, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.
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Abstract

Objective To identify the causes of revision of total knee arthroplasty in a referral center in Brazil.

Methods This is a case series, with 80 patients undergoing revision surgery for total knee arthroplasty (RTKA) at a referral center for knee surgery, between August 2019 and November 2021, with a mean age of 69.6 years. Of these patients, 60.23% were female and 39.77% were male. The average body mass index (BMI) was 30.23 kg/m2. The causes of TKA failure were defined as: periprosthetic infection according to the 2018 International Consensus Meeting criteria, ligament instability, range of motion limitation, periprosthetic fracture, malalignment, aseptic loosening, pain due to non-replacement of the patellar cartilage, polyethylene wear, fracture of implants, insufficiency of the extensor mechanism.

Results Periprosthetic joint infection (PJI) was the main cause of revision total knee arthroplasty (TKA), corresponding to 47.73% of cases. Aseptic loosening of one or more components represented the second most frequent reason for TKA failure, accounting for 35.23% of revisions. Range of motion limitation represented the third most frequent cause, accounting for 5.68% of surgeries. Instability was the fourth most frequent reason for RTKA, occurring in 4.55% of patients. The other causes of revision were: periprosthetic fracture (3.41%), failure due to rupture of the extensor mechanism (2.27%), and pain attributed to non-replacement of the patellar cartilage (1.14%).

Conclusions Periprosthetic joint infection was the most frequent cause of TKA revision in our series. Other reasons for TKA failures were, in descending order: aseptic loosening, limited range of motion, and instability.

Keywords

arthroplasty - arthroplasty, replacement, knee - infections - knee joint

Work carried out at the Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brazil.




Publication History

Received: 19 April 2022

Accepted: 17 August 2022

Article published online:
07 December 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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